MEDICARE: MRS. BROOKE C FORCHE LISW-S, MSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	I.2405369	OH

General Provider Information

NPI Number	:	1093470015
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BROOKE C FORCHE LISW-S, MSW

Provider Business Mailing Address
First Line	:	6545 W CENTRAL AVE STE 202
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43617-1034
Country	:	US
Telephone Number	:	419-318-9044
Fax Number	:

Provider Business Practice Location Address
First Line	:	6545 W CENTRAL AVE STE 202
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43617-1034
Country	:	US
Telephone Number	:	419-318-9044
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/04/2021
Last Update Date	:	03/04/2026

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